Women tend to live longer than men, and thus typically have more interactions with the healthcare system in old age than men do. Ageism and stereotypes of older people in general can have an ...important impact on elders’ physical and mental health and well‐being. For example, internalized negative stereotypes can produce self‐fulfilling prophecies through stereotype embodiment and contribute to weakness and dependency. Ageist beliefs and stereotypes can interfere with health care seeking as well as with diagnosis and treatment recommendations; they can, for example, contribute to gender disparities in the health care of older adults if older women are perceived as too frail to undergo aggressive treatments. Ageism also results in disrespectful treatment of older patients, which is communicated through baby talk and other forms of infantilization or the shrugging off of patients’ complaints and concerns as “just old age.” Intersectional identities can result in a cumulative burden for older women patients who may have a history of disrespectful treatment for other reasons (e.g., sexism, racism, bias against lesbians). Reduction of ageism and sexism and promotion of more realistic and diverse views of older women could improve doctor–patient relationships, facilitate adherence to treatment regimens, and reduce disparities in health and health care.
Telemental health conducted via videoconferencing (TMH-V) has the potential to improve access to care, and providers' attitudes toward this innovation play a crucial role in its uptake. This ...systematic review examined providers' attitudes toward TMH-V through the lens of the unified theory of acceptance and use of technology (UTAUT). Findings suggest that providers have positive overall attitudes toward TMH-V despite describing multiple drawbacks. Therefore, the relative advantages of TMH-V, such as its ability to increase access to care, may outweigh its disadvantages, including technological problems, increased hassle, and perceptions of impersonality. Providers' attitudes may also be related to their degree of prior TMH-V experience, and acceptance may increase with use. Limitations and implications of findings for implementation efforts are discussed.
Public Health Significance
Mental health providers can conduct appointments remotely via videoconferencing, a form of telemental health (TMH-V) which can increase access to care for patients who live far from specialty providers or have difficulty leaving their homes. It is important to understand providers' attitudes toward this technology, as they play a crucial role in whether this service will be widely adopted by health-care systems and will therefore be offered to patients. The current review found that providers feel positive toward TMH-V despite reporting multiple drawbacks; this suggests that the relative advantages of TMH-V, such as its ability to increase access to care, may outweigh its disadvantages, including technological problems, increased hassle, and perceptions of feeling impersonal.
Patient engagement has gained increasing prominence within academic literatures and policy discourse. With limited developments in practice, most extant academic contributions are conceptual, with ...initiatives in the National Health Service (NHS) concentrating at macro- rather than at micro-level. This may be one reason why the issue of 'value co-creation' has received limited attention within academic discussions of patient engagement or policy pronouncements. Drawing on emerging ideas in the services marketing and public management literatures, this article offers the first elucidation of the importance of studying 'value co-creation' as a basis for further empirical analysis of patient engagement in micro-level encounters.
We previously proposed that socioeconomic status (SES) is a fundamental cause of health inequalities and, as such, that SES inequalities in health persist over time despite radical changes in the ...diseases, risks, and interventions that happen to produce them at any given time. Like SES, race in the United States has an enduring connection to health and mortality. Our goals here are to evaluate whether this connection endures because systemic racism is a fundamental cause of health inequalities and, in doing so, to review a wide range of empirical data regarding racial differences in health outcomes, health risks, and health-enhancing resources such as money, knowledge, power, prestige, freedom, and beneficial social connections. We conclude that racial inequalities in health endure primarily because racism is a fundamental cause of racial differences in SES and because SES is a fundamental cause of health inequalities. In addition to these powerful connections, however, there is evidence that racism, largely via inequalities in power, prestige, freedom, neighborhood context, and health care, also has a fundamental association with health independent of SES.
Few industries match the scale of health care. In the United States alone, an estimated 85% of the population has at least 1 health care encounter annually and at least one quarter of these people ...experience 4 to 9 encounters annually. A single visit requires collaboration among a multidisciplinary group of clinicians, administrative staff, patients, and their loved ones. Multiple visits often occur across different clinicians working in different organizations. Ineffective care coordination and the underlying suboptimal teamwork processes are a public health issue. Health care delivery systems exemplify complex organizations operating under high stakes in dynamic policy and regulatory environments. The coordination and delivery of safe, high-quality care demands reliable teamwork and collaboration within, as well as across, organizational, disciplinary, technical, and cultural boundaries. In this review, we synthesize the evidence examining teams and teamwork in health care delivery settings in order to characterize the current state of the science and to highlight gaps in which studies can further illuminate our evidence-based understanding of teamwork and collaboration. Specifically, we highlight evidence concerning (a) the relationship between teamwork and multilevel outcomes, (b) effective teamwork behaviors, (c) competencies (i.e., knowledge, skills, and attitudes) underlying effective teamwork in the health professions, (d) teamwork interventions, (e) team performance measurement strategies, and (f) the critical role context plays in shaping teamwork and collaboration in practice. We also distill potential avenues for future research and highlight opportunities to understand the translation, dissemination, and implementation of evidence-based teamwork principles into practice.
Transition research in each disease group is developing in its own "silo." A comprehensive review of barriers to transition within and across chronic illness groups is needed to facilitate ...information sharing and larger-scale efforts to overcome barriers and improve patient care. This study systematically reviews and identifies the barriers to transition from pediatric to adult care across pediatric illness populations.
Medline, CINAHL, PsychINFO, Social Services Abstracts, Web of Science, and the Cochrane library databases were searched. Peer-reviewed English articles presenting original data on barriers to transition to adult care, focused on a specific pediatric chronic illness population, and conducted in the United States were included. Study design, population, and barriers were extracted. Barriers were categorized according to the Socioecological Model of Adolescent/Young Adult Readiness to Transition. Articles were evaluated for study quality.
Fifty-seven articles were included. The most common barriers to transition fell within the "Relationships" domain (e.g., difficulties letting go of long-standing relationships with pediatric providers) followed by "Access/Insurance" (e.g., difficulty accessing/finding qualified practitioners, insurance issues), and "Beliefs/Expectations" (e.g., negative beliefs about adult care). Barriers related to "Knowledge" (e.g., limited patient/caregiver knowledge about medication/illness and the transition process) and "Skills/Efficacy" (e.g., lack of self-management skills) were also common. While relationship barriers were commonly reported by all, some barriers varied by transfer status (pre- vs. posttransfer).
Each chronic illness group experiences illness-specific challenges but certain barriers transcend chronic illness populations. Suggestions to overcome these barriers are provided.
The international response to Ebola brings into stark contention the conspicuous invisibility of women and gender in global health governance. Developing feminist research on gender blindness, care ...and male bias, this article uses Ebola as a case to explore how global health rests on the conspicuous free labour of women in formal and informal care roles, yet renders women invisible in policy and practice. The article does so by demonstrating the conspicuous invisibility of women and gender in narratives on Ebola, emergency and long-term strategies to contain the disease, and in the health system strengthening plans of the World Health Organization and World Bank.
The Age of Ageism Nelson, Todd D.
Journal of social issues,
03/2016, Letnik:
72, Številka:
1
Journal Article
Recenzirano
This article discusses how research on ageism has gained more attention, especially as the baby boomers have started retiring, shepherding in an era that some call “the graying of America.” As the ...population of the country aged 65 and over is projected to double by 2030, it is especially important to study and help reduce age prejudice, so that the lives of older people can be improved. The papers presented in this issue represent some of the best empirical and theoretical work on the influence of ageism on the workplace environment and on healthcare for the older adult. These papers are summarized, and their recommendations for change in policy, law, and education are further highlighted.
The Issue: Coronavirus-19 (COVID-19) is transforming every aspect of our lives. Identified in late 2019, COVID-19 quickly became characterized as a global pandemic by March of 2020. Given the rapid ...acceleration of transmission, and the lack of preparedness to prevent and treat this virus, the negative impacts of COVID-19 are rippling through every facet of society. Although large numbers of people throughout the world will show resilience to the profound loss, stress, and fear associated with COVID-19, the virus will likely exacerbate existing mental health disorders and contribute to the onset of new stress-related disorders for many. Recommendations: The field of traumatic stress should address the serious needs that will emerge now and well into the future. However, we propose that these efforts may be limited, in part, by ongoing gaps that exist within our research and clinical care. In particular, we suggest that COVID-19 requires us to prioritize and mobilize as a research and clinical community around several key areas: (a) diagnostics, (b) prevention, (c) public outreach and communication, (d) working with medical staff and mainstreaming into nonmental health services, and (e) COVID-19-specific trauma research. As members of our community begin to rapidly develop and test interventions for COVID-19-related distress, we hope that those in positions of leadership in the field of traumatic stress consider limits of our current approaches, and invest the intellectual and financial resources urgently needed in order to innovate, forge partnerships, and develop the technologies to support those in greatest need.
Clinical Impact Statement
The novel coronavirus-19 (COVID-19) has rapidly emerged as a global pandemic placing unpresented stress on all aspects of society. The virus is likely to exacerbate and increase stress-related disorders for many throughout the world. Although those in the field of traumatic stress can play an important role in the immediate and long-term response to COVID-19, existing gaps in research and clinical care may limit our efficacy. We propose that there is an urgent need to reduce critical gaps in several key areas as we confront this unprecedented challenge and develop novel methods for empowering communities and supporting those in greatest need.
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